Tests Used to Diagnose Endometriosis
Posted on 06. Mar, 2011 by Allyson Drewry in Health
Doctors often say that they only want to run a few tests and give you some prescriptions just before the visit ends. You read the prescription for awhile, which are of course unreadable and unintelligible, and wonder, “What test? Why should I have it? What can I benefit from them? Hopefully, if your doctor is communicative and kind enough to explain about everything, you shouldn’t be worried. Otherwise, this article may give you some insights on this subject.
Blood test
Some tests can help doctors to diagnose endometriosis. As a matter of fact, without blood tests they can’t prove or disprove the diagnosis. So, you need to accept it when the nurse comes to you with a large needle on her hand. Although endometriosis doesn’t have a special type of blood test, a test called CA125 is a common tool used, because women with pelvic endometriosis often have higher CA125 level. It is usually caused by the irritation on the peritoneal surface. However, certain diseases, like ovarian cancer and fibrosis can also be indicated by higher CA125 level, as the result, the test is not a completely reliable way to diagnose endometriosis. In many laboratories, a normal CA125 level is considered to be below 35 U/ml. Current researches are often focused on the endometriosis diagnosis using cytokines that appear due to endometriosis inflammation. Down the road, researchers can identify certain endometriosis gene markers, which allow them to accurately isolate those markers during a blood test. Women who are trying to get pregnant, may also need to undergo blood test to evaluate their ovarian functions, which can be determined by measuring FSH, progesterone and estrogen levels.
Stool examination
Stool guaiac or hemoccult is used to check the presence of blood in stools. If the result is positive, another test will be performed to determine the source. Intestinal endometriosis can cause blood presence in the stools during the menstrual period, so this test can in some cases indicate the presence of endometriosis. It may appear quite disgusting, the gynecologist takes some sample with his gloved fingers from your rectum. The sample is smeared to a special paper and if blood is present, the paper color will change.
Urinalysis
Bladder endometriosis will definitely cause abnormalities in the urine, so it is important to have a urinalysis. Unless, you’re klutzy, urinating into a small cup shouldn’t be too difficult. Before the test, it is advised to drink a good deal of water, which can allow you to quickly finish your business without too much troubles. A urinalysis can diagnose many conditions including urinary tract infections and also liver and kidney problems. These are things that urinalysis can check:
• Leukocytes
• Sugar
• Protein
• Nitrates (a sign of bacterial growth)
• Ketones (a sign of tissue breakdown
• Bilirubin
• Blood
• Bacteria
These are things that shouldn’t be found inside the urine and although it is hard to believe, urine is normally sterile from living organisms. However, during the test, your urine can be easily be contaminated by skin bacteria and vaginal secretions. So, using a soapy cloth before urinating is necessary to avoid false diagnosis.
Ultrasound
Uterine anomalies, pelvic problems, swollen or distorted fallopian tubes can be detected effectively with ultrasound. The machine uses ultrasound to bounce sound waves off tissues and internal organs, also for detecting difference in tissue density. The method can also allow you to see whether most organs have normal density, shape, location and size. These are two types of ultrasound examinations:
• Transvaginal: The operator or the doctor will insert a probe into the vagina, from the cervix until the end of the vagina, at the start of the abdominal cavity. Because ovaries are supposed to be in this location, the transvaginal ultrasound can give better views on various tubes and ovaries problems (especially for endometriomas and ectopic pregnancy).
• Transabdominal: It is the least invasive approach and also the most commonly used. Doctors recommend the use of this method for obstetrics purposes. It can also be used to check position of internal organs, to check the uterus and to detect fibroids.
Often, both methods are performed consecutively to obtain the highest amount of information possible.
HSGs, SIS, CT scans and X-rays
There are a number of tests that allow doctors check your insides better, especially for women with endometriosis who plan to get pregnant. Some of these methods are more effective in detecting endometriosis than others.
• HSG (Hysterpsalpingogram): A dye will be passed through your fallopian tubes and uterus. The test can detect the presence of dilation and blockage that is caused by adhesions, and also any uterine anomaly.
• SIS (Saline Infusion SOnohysterogram): This test is performed to understand the patient’s endometrial cavity and uterus better. The test is performed by inserting a tiny tube into the uterus, then a saline solution is infused into your endometrial cavity while the ultrasound examination is being performed.
• CT Scan: It can detect cysts, obstructions and masses and also help operator determine between endometriosis and other objects. It scans the body in multiple slices, which allows doctor to get more distinct images. Its resolution is also much better than typical X-ray pictures.
• X-Ray: It is a simple examination method, which is useful for examining some soft tissues and bony structures, such lungs or ribcage. Unfortunately, it can’t differentiate endometriosis from other obstruction or masses.
Magnetic Resonance Imaging (MRIs)
It is consisted of a large tube where you can slide into, so that a specific are of your body can be examined using the magnetic field. MRI is essentially a tube-shape magnet. This equipment can detect endometriosis accurately if the lesion at least one inch in diameter. You should be aware that MRI is among the most expensive examination method, but can be necessary if doctors want to distinguish abnormalities detected by other equipments. Unfortunately, MRI sees cysts rather poorly, but it can help in ruling out pelvic abnormalities or fibroids. Compared to CT Scan, MRI is much more precise in examining soft tissues, but it can’t work well on bones. If CT Scan can only scan horizontally, MRI operator can control his device to take images from many different angles.
Because MRI uses a powerful magnet, it can easily attract metal objects even those inside your body. You should avoid MRI if you have:
• A cochlear implant
• A pacemaker
• Small metal pieces that can’t be removed with surgery
• Metal clips inside your body, including the brain
• Braces
• Dental bridges
• Pierced tongue, toe rings, belly button ring and other decoration made from metals
